To be a useful tool for assessing quality of physician care, pay-for-performance must be designed to include process measures and to not penalize physicians for treating patients with difficult-to-manage conditions.
A case that illustrates how Western medicine's body or mind approach to diagnosis and treatment can differ from that of many patients from non-Western cultures.
Appropriate use of the pay-for-performance system may improve quality of care by counteracting physician incentives to overtreat in fee-for-service situations or undertreat in capitation plans.
Several recent court cases illustrate how some states are attempting to mandate physician reporting of all underage sexual activity as instances of child abuse.